Wife’s wary about sex after hubby’s heart attack
Submitted by: Marc C. Gittelman, M.D.
Submitted on: October 10, 2006
Q: My husband had a heart attack three years ago and is doing well and exercising on a regular basis. He wants to have sex every week or so, but I am scared that it will kill him. His doctor says that everything is fine, but the last thing I want to do is have my husband die in bed making love!
A: There is an integral link between the blood flow to the heart and the blood flow in the penis. As men age and we expose our bodies to increased fats and elevated cholesterol, the blood vessels in our heart and penis narrow with plaque. If a man has erectile dysfunction (ED), there is a good possibility he is developing cardiovascular problems at the same time. In fact there is such a close association that we can predict that heart problems are likely to lead to ED and ED is likely to be an early sign of heart problems. If a man has angina or sustained a myocardial infarction (MI) or a stroke, his chances of having erection problems doubles or triples. Eating well, losing weight and exercising can clearly decrease a man’s risk for heart disease and also a man’s risk for erectile dysfunction.
The good news is that the vast majority of men who have sustained a cardiac problem can safely resume sexual activity. A group of renowned physicians wrote the Princeton Consensus Panel, which helped to define who is at high or low risk for heart problems. The majority of patients fall into the low-risk category, for whom sexual activity does not pose a significant cardiac risk. The low risk group includes men with fewer than three major risk factors for cardiovascular disease, and whose hypertension is well controlled and whose coronary revascularization is adequate. Even men with a history of MI more than eight weeks previously are considered low risk as long as they pass their post-MI stress test. Those patients who are assessed at low risk and have ED can resume sexual activity and can even be treated safely with medicines that improve erections.
Ultimately it will be up to your husband’s cardiologist to determine whether it’s safe to resume sexual relations. And once you resume, start slowly. This is the time for good partner communication. Sustaining any major health issues can be unsettling. The closeness and intimacy that cuddling and lovemaking provide for both you and your husband may also turn out to be a major positive in not only he physical healing but also the psychological healing.